In this assignment, an individual must show the ability to apply the value chain
ID: 343475 • Letter: I
Question
In this assignment, an individual must show the ability to apply the value chain model in an organisation. How Did 94 Psychiatric Patients Die? The Life Esidimeni Deaths Explained. A report in South Africa detailing the death of 94 people with mental health disorders who were moved from the Life Esidemeni Hospital and placed in inadequate facilities has sparked outrage and led to Qedani Mahlangu stepping down as the local government Minister of Health in Gauteng province.
Read the the below case study for the Life Esidimeni Deaths below
How The Hell Did 94 Psychiatric Patients Die? The Life Esidimeni Deaths Explained.
Here's why things went so badly wrong, and what should happen now, courtesy of Section27.
Staff Reporter
South Africans are reeling following the shock news by the health ombudsman that 94 psychiatric patients, and counting, have died during the chaotic move from Life Esidimeni hospital by the Gauteng Health department — against repeated advice, legal action and entreaties from experts, activists and the families of the patients.
This is the full report on the matter by the Health Ombud Professor Malegapuru William Makgoba.
NGO Section27 was one of the organisations involved in trying to stop the department through legal action. They have released the following fact sheet to help explain the events leading up to the tragedy.
What happened?
In October 2015, the MEC for Health in Gauteng, Qedani Mahlangu, announced the termination of the contract between the Department of Health and Life Esidimeni. Around 2000 people, who were receiving highly-specialised chronic psychiatric care, were to be moved out of Life Esidimeni to families, NGOs and psychiatric hospitals providing acute care.Why close? The MEC claimed:
To save money
To deinstitutionalize (the policy says to do so slowly, over several years, after developing and capacitating community care)
From March to June 2016, mental health care users were discharged from Life Esidimeni in large numbers, with the last discharges happening in June.
In September 2016, the MEC reported to parliament that 36 former residents of Life Esidimeni had died, including Virginia Machpelah, who died along with a number of others at the same NGO.
What were the legal consequences of the move?
The way in which mental health care users were discharged from Life Esidimeni was in breach of their rights under the Constitution and the Mental Health Care Act, including the following:
The right to health care services under section 27 of the Constitution, and the National Health Act and the Mental Health Care Act: not only were they not receiving the care that they required, but the discharge of these patients resulted in a poorer level of heath care than what they received at Life Esidimeni
The right to dignity under section 10 of the Constitution and the Mental Health Care Act
The right to life under section 11 of the Constitution
The protection given to mental health care users against neglect, guaranteed by the Mental Health Care Act
Did anyone try to stop the move?
Families, civil society organisations and professional associations all tried desperately to convince the Department it was placing patients in danger by moving them to places that could not give them the care they required. They were even forced to take the Department to court twice.
June 2015 – the South African Society of Psychiatrists (SASOP) wrote to the MEC about the risks. SASOP warned the closure was "premature" and "in contradiction" of the policy. It predicted the negative outcomes that have now occurred.
November 2015 – South African Depression and Anxiety Group (SADAG), SASOP, the SA Federation for Mental Health (SA Fed), and families of Life Esidimeni residents met the Department and asked it to slow down and follow the correct procedure to ensure proper care for the patients.
December 2015 – Litigation against the Department led to a settlement agreement in which the Department committed to a consultation and a safe process, in the best interests of the mental health care users. It undertook that nobody would be moved until there was agreement on the process and facilities.
March 2016 – Litigation against the Department to try to stop the transfer of 54 people to Takalani NGO. The Department argued that patients had been assessed and were no longer in need of professional care and Takalani was safe. Although they had previously agreed to consult with stakeholders, they made this decision without consultation, arguing that they had no obligation to consult. The court ruled that the Department could transfer the patients. Patients sent to Takalani, it turned out, were actually diagnosed as having "severe intellectual disability" and being entirely dependent on others for care. The Department had misled the court and allowed the transfer of patients to a facility that was not able to meet their needs.
Families met with the Department repeatedly to demand safe, dignified care and marched against the Department with their demands three times. They received no substantive response.
How could they have known it would go so wrong?
The national and provincial health departments' own policies predicted this outcome. In addition, experts and families uniformly and repeatedly warned of the consequences. Finally, the Department was told what would happen in the course of two rounds of litigation
National Mental Health Policy
Notes "Deinstitutionalisation has progressed at a rapid rate in South Africa, without the necessary development of community-based services. This has led to a high number of homeless mentally ill, people living with mental illness in prisons and revolving door patterns of care." (page 16)
Warns of the dangers of further premature deinstutionalisation and the current insufficiency of community based care
Gauteng Mental Health Policy
Plans for a gradual reduction of beds at Life Esidimeni (10% a year), leaving 1200 by 2019/20 with accompanying development of community based care
SASOP letter to Department of Health in June 2015
Warned "unintended, costly, negative consequences" would result
Noted it would worsen the "revolving door of care" where people move out of facilities, through prisons and homelessness and back into facilities where they have to be restabilized
Warned that it would cause "greater district health costs as [users] get re-hospitalised"
Warned community based care facilities were too few and do not have space, equipment, staff or expertise to deal with the patients. Warned also that the psychiatric wards and hospitals were already over-capacity
2015 litigation
Department presented documents that showed that it knew that most people needed higher levels of care than provided in NGOs/at home
Applicants laid out problems with facilities identified
Expert psychiatrist gave evidence that Life Esidimeni had accommodated people who had already unsuccessfully been to other facilities. While deinstitutionalization is desirable for patients who can cope with it, Life Esidimeni would always be the most appropriate level of care for some people o
Family members gave evidence of vulnerability of loved ones and the inability of families to provide the needed care
What should happen now?
Political, civil and criminal accountability for those responsible
Inquests into all deaths to establish causes and the appropriate steps that should follow
Appointment of a curator for each former Life Esidimeni resident to look after their safety and interests
Remove surviving former residents of Life Esidimeni out of dangerous NGOs and into safe, dignified facilities that cater to their needs
Appropriate plan in place for mental health care services in Gauteng to avoid a similar incident in the future
Questions below
From further research describe, draw a diagram and explain the value chain of mental health care in South Africa. Use the value chain theory and examples from the articles to answer the question. You must identify and discuss primary, supporting activities, value adding and non-value adding elements, weaknesses and strengths (40 marks)
Critically examine the demand to make use of NGOs in the value chain for mental health care in South Africa. You can make assumptions based on your detailed further research.
How will you evaluate and plan mental health services to avoid deaths of metal health patients in future. Use any of the processes described in the textbooks or the articles as a guideline to draw the diagram. Your diagram must be as detailed as possible. The diagram must be accompanied by a description of the activities such as political buy-in, community, programme resources, medical health care profession (MHCP), capacity building, identification, treatment and care, long-term outcome, impact and other related activities. In the process, clearly indicate the value-adding links. (60 marks)
Explanation / Answer
A, If we can analysis value chain then we can see mainly to parts:
Support activity :
We find here firm insfrastructure was good with all support system but it was broken after breaking the contract between health cares. Under this firm infrastructure we can see some points are their like generel management ,accounting, strategic planning etc. these are the main support system here which will help them for financing part but if that part will demolish then it a very big problem to survive. hence here they are being very fragmented from different aspects. Infrustructure was broken gradually .Next part is Human resouce management so that this will be a core portion in the organization. Training and development is under this division. SO that that also create value here to inccrease organizational profit and developement . Here mismanagement and misleds goes wrong into society. Their moral value has dropped so that hey have taken such a bad decision here. Now if we can see technological developement then it is clearly shows that R&D and products and other process should help them out to become old position, but then fails to convince them and they was very much careless here to identofy this problem. Technologiacalmisleeding also a problem here . That fully suffered by patients. Hence lastly procurement , here value should be generated from Raw meterials importing and NGO should take care here logically. this would be very common things for an health care. As we all know big machinaries is also very much required for this process. So that here also they shows moral dibalence nature very firmly. Supplies of medicines also very urgent requirement here for patient but this duties are totally overlooked.
Primary Activity :
Here we can see different part of segements.
B. We can draw a core function to develope more powerfull value chain analysis for healthcare :
If we produce two ways activties and actors:
input supplyL
Activities: Extension service, Patient health service, Credit access of patient,
Actor: NGOs
Production : New patient with full care with all benefits, proper connection with hospitals and their 24hours monitoring by doctors and nurse.
Marketing adverisement: It is very impotent cash generation part where they can approaches to other company they will sponsores them to get big position in market. Different parties from differents organization and from Govt also they can get help for their health care
Value chain has a great soieal value that will help patients very greatly .
Firm infrastructure Human resource management Technology Developement procurement of resources